What are the methods for treating skin cancer?

Skin cancer refers to a malignant tumor that occurs on the epidermis of the skin. Skin cancer is more likely to occur on exposed parts of the body. The occurrence of skin cancer is related to long-term exposure to sunlight, X-rays and thermal radiation, and frequent contact with chemicals such as petroleum, asphalt, arsenic, and tar.

The appropriate treatment is not only based on the histological type of skin cancer, but also on the anatomical site, patient age, sex, and general health. In terms of anatomical sites, attention should be paid to whether certain sites are prone to recurrence after surgery, and whether certain sites can achieve the expected effect of the treatment plan. For example, the orbital area, nose area, and ear area are areas with a high recurrence rate, so a treatment with a higher cure rate must be selected. Before surgical resection, the cosmetic appearance of the wound at the anatomical site and the function of the skin after resection should be considered.

The general health of the patient should be considered comprehensively. If there is a coagulation disorder or anticoagulant therapy, non-bleeding treatment must be used. Cryotherapy, C02 laser, and radiotherapy can all be used. Elderly and weak female patients may not be able to tolerate long-term radiotherapy. Curettage and electrical desiccation can be used, or surgical complete resection can be used.

1. Drug treatment

Local treatment: mainly local application, local compress and local injection.

Systemic treatment

Indications: Systemic chemotherapy is required for squamous cell carcinoma that occurs on the basis of existing scars, squamous cell carcinoma at the junction of the skin and mucosa, patients with impaired immune function, and those with regional lymph node and distant metastasis.

(II) Scraping treatment Skin scientists generally use scraping and electrodesiccation to treat basal cell carcinoma and superficial squamous cell carcinoma. This is done by using the boundary between the tumor and the normal skin color around it. Scraping is done with a curette. Before the operation, attention should be paid to the appropriate size of the curette, which is generally slightly larger than the neoplasm. During the operation, a slight downward force should be applied to prevent slippage. Sometimes, because the normal dermis is relatively solid, a slight gravel-like sound can be heard during scraping, while the tumor is crisp and silent. After scraping, an electrocautery device is used to burn the surroundings and base of the tumor bed, and then the charred tissue is scraped off with a curette. The wound is coated with antibiotic ointment. Its advantage is that a smooth and beautiful wound with only a small amount of pigmentation can be obtained. The disadvantage is that there is no pathological examination result of the cutting edge, and it is impossible to understand whether there is cancer residue at the cutting edge. Therefore, this method should be used with caution.

(III) Cryotherapy Skin cancer that is suitable for curettage is also suitable for cryotherapy, especially some cases rich in fibrous components that are not conducive to curettage; cases that relapse after curettage and radiotherapy are more suitable for cryotherapy. However, the lesion must be limited to the skin. Those that invade other tissues and organs are not suitable for cryotherapy. A biopsy must be performed before treatment, because there is no specimen available for pathological examination after cryotherapy. After the surgeon marks the tumor boundary, the lesion and the surrounding 2 to 5 mm of normal tissue are used as the treatment area. -20℃ is the best temperature to ensure tumor cell lethality. Then start thawing. Slow thawing can kill tumor cells more effectively than rapid thawing. Rapid thawing is only used to prevent damage to more normal tissues.

(IV) Radiotherapy: Both basal cell carcinoma and squamous cell carcinoma are very sensitive to radiotherapy, which means they are very effective. Before deciding on radiotherapy, the patient's age, gender, tumor history, anatomical location, cure and recurrence, and the final cosmetic effect must be considered.

(V) Laser treatment There are many types of lasers commonly used in dermatology, such as carbon dioxide laser, helium-neon laser, etc., and their uses are different. Carbon dioxide laser is mainly used in the treatment of skin cancer, and carbon dioxide laser can replace the electric drying method. Carbon dioxide laser is an infrared beam with a wavelength of 10600nm. When the beam diverges, it can be used to vaporize skin tumors, such as basal cell carcinoma and superficial squamous cell carcinoma, making the skin tumor disappear, and can be used in combination with curettage.

(VI) Surgical treatment Surgery is still one of the main methods for treating skin cancer. The scope of resection should vary with the size of the tumor and the depth of infiltration. For basal cell carcinoma with small, superficial and clear lesions, resection 0.5 cm away from the edge of the tumor can generally achieve the purpose of healing. For cases with large lesions and extensive infiltration, resection should be performed 3 to 5 cm away from the primary lesion. Frozen section examination should be performed in hospitals with conditions. The local recurrence rate of basal cell carcinoma with negative margins is 1% to 5%. The scope of resection of the tumor base depends on the depth of infiltration of the lesion. For superficial basal cell carcinoma occurring on the scalp, extensive resection and skin grafting can be performed; if the periosteum is involved, the periosteum should be removed together and then a pedicled flap transplant and skin grafting repair should be performed. The scope of resection for squamous cell carcinoma is basically the same as that for basal cell carcinoma, but lymph node dissection should be performed for patients with regional lymph node metastasis.

(VII) Immunotherapy Studies on the use of interferon in the treatment of skin cancer have shown that immunotherapy may be an effective treatment in the future. Local injection of interferon γ2 into the tumor of basal cell carcinoma can provide short-term relief.

The above is some knowledge about the treatment of skin cancer that we have prepared for you today. I hope it can be helpful to you. If you have any other needs, you can also consult our online consulting experts. We are always here to answer your questions and give you more detailed guidance. I wish you health and happiness!

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